Lamm Bradley M, Siddiqui Noman A, Nair Ajitha K, LaPorta Guido
International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.
J Foot Ankle Surg. 2012 Jul-Aug;51(4):531-6. doi: 10.1053/j.jfas.2012.04.021. Epub 2012 May 24.
Midfoot Charcot collapse commonly occurs through the tarsometatarsal and/or midtarsal joints, which creates the characteristic "rocker bottom" deformity. Intramedullary metatarsal fixation spanning the tarsus into the talus and/or calcaneus is a recently developed method for addressing unstable midfoot Charcot deformity. The intramedullary foot fixation technique has various advantages when addressing midfoot Charcot deformity in the neuropathic patient. These advantages include anatomical realignment, minimally invasive fixation technique, formal multiple joint fusion, adjacent joint fixation beyond the level of Charcot collapse, rigid interosseus fixation, and preservation of foot length. The goals of the intramedullary foot fixation procedure are to create a stable, plantigrade, and ulcer-free foot, which allows the patient to ambulate with custom-molded orthotics and shoes.
中足夏科氏关节塌陷通常通过跗跖关节和/或中跗关节发生,这会形成特征性的“摇椅底”畸形。跨越跗骨至距骨和/或跟骨的髓内跖骨固定是最近开发的一种治疗不稳定中足夏科氏畸形的方法。在治疗神经性患者的中足夏科氏畸形时,髓内足部固定技术具有多种优势。这些优势包括解剖复位、微创固定技术、正式的多关节融合、夏科氏关节塌陷水平以上的相邻关节固定、坚强的骨间固定以及保留足长。髓内足部固定手术的目标是创建一个稳定、足底着地且无溃疡的足部,使患者能够穿着定制的矫形器和鞋子行走。